A spinal cord stroke is a sudden, often severe physical reaction to obstructed blood flow in the spine. If the main spinal artery or one of the smaller blood vessels in the spine is blocked, blood cannot reach the delicate nerve structures in the cord. The result is usually immediate radiating pain and weakness, followed shortly by lack of muscle control in the limbs and possibly paralysis. Many strokes in the spinal cord are reversible with prompt medical care and ongoing physical therapy. If a major blockage occurs, however, a person may have lifelong difficulties despite all treatment efforts.
Many different conditions can precede a spinal cord stroke. People who have atherosclerosis, a buildup of cholesterol plaques in their arteries, are at the highest risk of suffering strokes. The spinal artery or the aorta that feeds it can become dangerously narrow as plaques amass along the interior walls. Total blockages can occur when cholesterol deposits break free and become lodged in smaller blood vessels in the spine.
Other potential causes of spinal cord stroke include chronic diseases, acute infections, and injuries that cause damage to spinal blood vessels. Autoimmune conditions such as lupus may damage an artery to the point that it ruptures and hemorrhages. Syphilis infections and diabetes can also impair blood vessel functioning. Injuries associated with major spine trauma and complications of spinal surgery may occasionally result in a stroke as well. In some cases, an underlying cause is never discovered.
When a spinal cord stroke occurs, a person typically feels immediate, severe pain and tightness in his or her back. Burning and tingling sensations may radiate down the spine and into the legs. After a few minutes or hours, a person can lose all sensation and muscle control in the legs and lower torso. Bowel and bladder control also are often compromised. If the arterial blockage occurs near the top of the spinal cord, the arms may be affected as well.
Emergency medical care should be sought at the first signs of a possible spinal cord stroke. A team of doctors can assess the severity of the situation and look for an underlying cause by taking imaging scans of the spine, performing blood work, and asking about the onset of symptoms. Magnetic resonance imaging scans are usually effective at pinpointing the site of blood vessel damage or blockage. Electromyography tests are also conducted to identify the extent of nerve involvement.
In most cases, it is not possible to repair severely damaged arteries and nerves around the spinal cord. Treatment efforts generally are focused on improving blood flow and eliminating the underlying cause if possible. Patients may be given aspirin and other blood thinners as well as drugs to combat infections or pain. Some patients who suffer spinal cord strokes regain sensations spontaneously, while others require several months or years of physical therapy to overcome lingering muscle control problems.